Background: We conducted an economic evaluation of two community tuberculosis (TB) active case finding (ACF) strategies in Cambodia by assessing the cost per disability-adjusted life years (DALY) averted among people with TB. Methods: We analyzed program and national TB notification data from a cohort of people with TB in 12 intervention operational districts (ODs) and 12 control ODs between November 2018 and February 2020. The interventions comprised—1) ACF using a seed-and-recruit model and 2) one-off roving ACF that were implemented concurrently. Passive case finding, a default setup in the health system, was continuously present in both the intervention and control areas. We estimated costs using the program and previously published primary cost data in Cambodia. The primary outcome was the cost per DALY averted among people with TB in the intervention sites compared to the control sites. We considered an intervention to be cost-effective if the cost per DALY averted was lower than the gross domestic product per capita of Cambodia (US$ 1643 in 2018). Findings: In total, 12074 were screened and tested via the seed-and-recruit model and 51636 via the one-off roving ACF model. The former needed to test 7·7 presumptive TB to identify 1577 all-forms TB, while the latter needed to test 22·4 to identify 2303 all-forms TB. The cost per DALY averted was US$ 237 for ACF using a seed-and-recruit model, US$ 164 for one-off roving ACF. Interpretation: Community-based ACF interventions that targeted engagements with key populations for TB in Cambodia were highly cost-effective. Funding Statement: This study was funded by the Stop TB Partnership TB REACH Grant. Declaration of Interests: We declare no competing interests. Ethics Approval Statement: This study was approved by the National Ethics Committee for Health Research Cambodia (112/NECHR). A waiver of consent was granted due to the retrospective nature of this study, the minimal risk to rights and welfare of the participants, and the lack of practicality to obtain consent.